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Abstract

AIM: To investigate the prognostic significance for cardiovascular outcome of small artery structural changes in uncomplicated essential hypertension.

BACKGROUND: Small artery media-lumen ratio (M:L) is an important pathophysiological factor in essential hypertension. High M:L of small arteries isolated from subcutaneous gluteal skin biopsies has recently been shown to predict cardiovascular outcome in a heterogeneous high risk group of patients with type-2 diabetes, primary and secondary hypertension. However, since the abnormal M:L in diabetes is pressure-independent, the relevance of those findings to essential hypertension has been uncertain.

METHODS: We conducted a follow-up survey of a homogenous low-to-medium risk group of 159 patients with uncomplicated essential hypertension who had been included in clinical treatment studies. Mean follow-up was 10.4 years. All patients had an initial assessment of M:L using myography before starting therapy.